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Bipartisan members of Congress urge USPSTF to reevaluate screenings

October 06, 2015

U.S. Reps. Chris Smith (R-NJ) and Mike Doyle (D-PA), co-chairs of the Congressional Autism Caucus, authored a bipartisan, multi-member letter last week urging the US Preventive Services Task Force (USPSTF) to reconsider their draft recommendations on universal autism screenings. In August, the USPSTF called for more research on the benefits of universal screening for autism.

In its draft recommendations, the task force stated that, at present, evidence was “inconclusive” on the benefits of universal screening for autism at 18 and 24 months, an assessment which differs starkly from the guidelines set by the American Academy of Pediatrics. Those guidelines recommend universal screening children between the ages of 18 and 24 months.

The co-chairs highlighted the responses of The American Academy of Pediatrics, Autism Speaks, and the Autism Science Foundation as leading advocacy groups and professional associations voicing their concerns on the USPSTF draft recommendations.

At the release of the recommendations, Autism Speaks issued a joint statement with the Autism Science Foundation stating, “Screening leads to earlier identification of autism and opportunities for early intervention, which improves the lives of children with the disorder. The task force recommends that doctors rely on clinical judgment. This is not sufficient to identify all individuals with signs and symptoms of autism at an early age. Moreover, screening is quick, affordable and has no substantial risk.” Autism Speaks’ official response to the draft recommendations can be viewed here.

“The USPSTF’s recommendations ignore the work of scientists, medical researchers and advocacy organizations that have invested in raising the quality of life and enhancing the wellbeing of children and adults on the spectrum,” said Smith. “Early screenings lead to the early intervention services that remain critical for a child with ASD’s long-term development.”

“Early screenings for Autism Spectrum Disorder are a critical tool at our disposal to help us identify developmental disabilities and implement early interventions,” said Rep. Doyle. “We should screen all children to ensure they get the help they need to improve health outcomes and quality of life.

“While we understand that your recommendation urges doctors to use their judgment in determining which children shall be screened, given that an autism screening is cheap, quick and minimally invasive, universal screening should be required. The limited—if any—down side does not outweigh the tremendous benefits of early screening.

"It is undeniable that a delay in diagnosis leads to a delay in a child with autism receiving the early intervention and treatment services that are critical to their long term development. Effective and widespread screening can be the difference between a child’s ability to develop early language skills, socialize with other children, and eventually matriculate into a regular kindergarten classroom as compared to a lifetime of health, social, behavioral, and quality of life challenges if early developmental signs are ignored.

“If the USPSTF draft recommendation is finalized, families and their physicians could lose a critical screening test that identifies a spectrum of developmental disabilities that if diagnosed and treated early, can dramatically improve a child’s trajectory for the rest of his/her life.”

“We know that families who lack resources and have limited access to expert clinicians experience later diagnoses than most. If this recommendation is finalized, it will further exacerbate this problem for disadvantaged populations,” Smith continued. “I remain hopeful that the Task Force will listen to experts and organizations that have weighed in and will withdraw this ill-conceived recommendation.”

The co-chairs also highlighted the responses of The American Academy of Pediatrics, Autism Speaks, and the Autism Science Foundation, which are among the advocacy groups and professional associations speaking out against the USTSPF draft recommendation.